Public Health Dental Hygiene Dental  (PHDHP) Survey

I.  DEMOGRAPHICS

1.Location of personal residence (zip code)
2.Location of primary practice site (zip code)
3.Do you currently hold a PHDHP license?
4.If answered YES to Question #3, list license number and date issued:
5.Are you eligible for PHDHP licensure?
6.Do you currently hold a Local Anesthesia license?
7.If answered YES to Question #6, list license number and date issued:
8.Are you currently a School Certified Dental Hygienist?
9.Are you currently a Member of the ADHA?
Current Progress,
0 of 28 answered